Dynamic pressurized catheter with simultaneous oxygen delivery and suction

ABSTRACT

An apparatus and method is disclosed for an improved multi-tubed catheter for physically dislodging and removing material from a lung by suction and simultaneously aerating the lung with oxygen. The catheter comprises an oxygen tube for conveying oxygen into the lung, a suction tube adapted to remove material from the lung and an inflation tube for inflating a small balloon for separating the flow of oxygen from the suction. As the multi-tubed catheter is moved through the lung, the balloon mechanically dislodges material from the lung to be conveyed out of the lung through the suction tube. The lung is contiuously ventilated by oxygen during the removal process.

BACKGROUND OF THE INVENTION

1. Field Of The Invention

This invention relates to a catheter, and more particularly to anendotracheal bronchial suction catheter, that simultaneously removesmaterial from the respiratory tract of a patient and supplies oxygen toa patient.

2. Background Problem and Prior Art

In a number of medical situations, including routine surgery andintensive care, the breathing of a patient is assisted by artificialmeans such as a mechanical ventilator. When a mechanical ventilator isin use, air is forced into the lungs through the trachea via anendotracheal tube (ETT). The endotracheal tube (ETT) is inserted throughthe nose or mouth into the trachea of the patient so that a distal tipof the endotracheal tube (ETT) extends beyond the vocal cords of thepatient. When the patient is being assisted by a mechanical ventilatorthrough an endotracheal tube (ETT), the patient is referred to as beingintubated or ventilated.

The lungs and trachea of a person produce mucus continuously. Normally,the mucus of the respiratory tract is cleared from the airways bynatural means such as coughing. However, an intubated patient has nomeans by which to clear the respiratory tract of mucus, particularly ifthe patient is confined to a bed or the patient is unconscious. Overtime, mucus or other fluids collect in the airways of an intubatedpatient which interferes with the oxygen exchange in the lungs of theintubated patient. Accordingly, the mucus or the other fluids must beperiodically suctioned out of the lungs of the intubated patient.

In treatment situations where a solid or a fluid material, such asmucus, must be removed from a bronchial cavities or respiratory tract ofa patient, a problem arises of supplying the patient with oxygen whilethe solid or the fluid material is being removed by suction. Typically,a single hollow tube is inserted down the trachea of the patient and isdirected into a selected bronchus. The single hollow tube may be usedsequentially for two distinct and separate functions. First, the singlehollow tube is connected to a source of vacuum to remove the solid orthe fluid material by suction from the lungs of the patient. Second, thesingle hollow tube is connected to a source of pressurized oxygen toconduct an oxygen-rich gas into the lung so that the patient may besupplied with oxygen for respiration.

When a single tube is used sequentially, the tube is timeshared. When asingle tube is timeshared, the tube is used alternately connected to thesource of vacuum or the source of pressurized oxygen for alternatelywithdrawing the solid or the fluid material from the lungs of thepatient or for supplying the patient with oxygen for respiration. Thealternation between the source of vacuum and the source of pressurizedoxygen may be accomplished by a human operator or assisted by amechanical device.

Obviously, there are disadvantages associated with the alternate use ofa single tube withdrawing the solid or the fluid material from the lungsof the patient or for supplying the patient with oxygen for respiration.First, pressurized oxygen cannot be supplied to the patient until thesingle tube is cleared of all of the solid or the fluid material removedfrom the lungs or the pressurized oxygen will push the solid or thefluid material back into the lung. Second, the pressurized oxygen mayserve to undo the cleaning done by the previous vacuum suction. Third,the periods in which no oxygen is being supplied to the patient could bedetrimental and may cause hypoxia and the consequences thereof.

Heretofore, there have been a number of mechanical devices concernedwith the problems of endotracheal intubation and the removal of materialfrom the respiratory tract.

U.S. Pat. No. 4,468,216 to Muto describes an irrigation suction catheterwhich can be inserted into either a trachea or an esophagus of thepatient. The distal tip of the catheter comprises an irrigation tubedisposed within a suction tube. A fluid such as saline solution isemitted from the irrigation tube to dislodge particles while thedislodged particles are removed by the suction tube.

U.S. Pat. No. 4,327,720 to Bronson et al. discloses a device foraccessing the trachea of a patient enabling the insertion of a suctiontube or a fiber-optic scope. The device is primarily concerned withrectifying a common problem of accidentally inserting the suction tubeor the fiber-optic scope within the esophagus instead of the trachea orvice-versa.

U.S. Pat. No. 4,041,936 to Carden discloses a device for insertion intothe respiratory tract of a patient to give access to a fiber-optic scope(FOS). A tube and a tip of the device is adapted to allow forced-airventilation of the lung during the examination of the respiratory tractof the patient. The tip of the tube comprises an inflatable cuff bywhich a portion of the respiratory tract may be sealed off andpressurized. Although the provides a means for visually inspecting thelung, the device is not designed for routinely removing materials fromthe lung. It is well known that the insertion of a fiber-optic scope(FOS) requires a special medical procedure as well as the specialpreparation of a patient since the insertion of a fiber-optic scope(FOS) has the risk of perforating the lung thus causing a hemorrhage.Accordingly, the only specially trained physicians are able to insert afiber-optic scope (FOS) into the lung of a patient. Since the insertionof a fiber-optic scope (FOS) into the lung of a patient is a specializedprocedure, fiber-optic scope (FOS) is not suitable for mechanicallycleaning an air passage.

U.S. Pat. No. 4,244,362 to Anderson describes a means for directing anendotracheal tube (ETT) through the larynx and into the trachea. Sincethe insertion of an endotracheal tube (ETT) through the larynx and intothe trachea is a very delicate technique, the device incorporates amagnetic tip to guide the endotracheal tube (ETT) into the trachea bymeans of a magnet disposed outside of the patient.

Although the aforementioned devices have contributed to the prior art,none of the aforementioned devices considered the problems of (1)maintaining both a constant suction and a constant supply of oxygen tothe patient, (2) providing a mechanical dislodging of thick andtenacious material from the walls of the bronchi in the lung and (3)positioning the suction down stream from the flow of the oxygen enablingthe oxygen stream to assist in the removal of the material from thewalls of the bronchi in the lung.

Therefore, it is an object of the present invention to overcome thedisadvantages associated with the alternate use of a single tubewithdrawing the solid or the fluid material from the lungs of thepatient or for supplying the patient with oxygen for respiration.

Another object of the invention is to provide an improved device formaintaining both a constant suction and a constant supply of oxygen tothe patient, and for providing a mechanical dislodging of thick andtenacious material from the walls of the bronchi in the lung.

Another object of the invention is to provide an improved device forremoving material from the respiratory tract.

The foregoing has outlined some of the more pertinent objects of thepresent invention. These objects should be construed as being merelyillustrative of some of the more prominent features and applications ofthe invention. Many other beneficial results can be obtained by applyingthe disclosed invention in a different manner or modifying the inventionwith in the scope of the invention. Accordingly other objects in a fullunderstanding of the invention may be had by referring to the summary ofthe invention, the detailed description describing the preferredembodiment in addition to the scope of the invention defined by theclaims taken in conjunction with the accompanying drawings.

SUMMARY OF THE INVENTION

The present invention is defined by the appended claims with specificembodiments being shown in the attached drawings. For the purpose ofsummarizing the invention, the invention relates to an improved methodand apparatus relating to a multi-lumen catheter which may be insertedinto a lung through the trachea, by way of either an endotracheal tube(ETT) or tracheostomy. The multi-lumen catheter is directed to aselected bronchus in the lung.

The multi-lumen catheter suction tube having a first end a second endwith a suction tube lumen extending therebetween. The suction tubedefines a suction tube opening proximate the second end of the suctiontube. An oxygen tube comprises a first end a second end with an oxygentube lumen extending therebetween. The oxygen tube defines an oxygentube opening proximate the second end of the oxygen tube. An engagingmeans is interposed between the suction tube opening and the oxygen tubeopening for engaging a surface in the lung. The first end of the suctiontube is connected to a source of vacuum for conveying material out ofthe lung by suction whereas the first end of the oxygen tube isconnected to a source of oxygen for simultaneously conveying oxygen intothe lung.

In a specific embodiment of the invention, the oxygen tube is helicallyformed within and secured to the suction tube lumen. The oxygen tubecomprises a plurality of oxygen tube openings including an end wallopening being disposed in the second end of the oxygen tube and asidewall opening being disposed in a sidewall of the oxygen tube.

The engaging means comprises an inflatable balloon secured relative tothe suction tube with an inflation tube having a first and a second endwith an inflation tube lumen extending therebetween. The inflation tubedefines an inflation tube opening proximate the second end of theinflation tube. The first end of the inflation tube is connected to asource of gas pressure for inflating the balloon. In one embodiment ofthe invention, the inflation tube is disposed within a sidewall of thesuction tube.

In use, the multi-lumen catheter is directed to a selected bronchus andinserted as far as desired into the bronchial cavity. When themulti-tubed catheter is in place, the balloon is inflated so that theballoon contacts the sidewall of the bronchus and a forms a seal betweenthe sidewall of the bronchus and the balloon to isolate oxygen tubeopening from the suction tube openings. The multi-lumen catheter may beleft in place or, if required, pulled to mechanically remove thick andtenacious secretions from the bronchus and trachea by the scrapingaction of the balloon against the bronchial sidewall. Once thesesecretions are mechanically dislodged, the secretions are removed fromthe lung through the suction tube.

While removal of material from the lung is taking place, oxygen is beingcontinuously supplied to the patient through the oxygen tube opening.Accordingly, suction and ventilation of the patient occur simultaneouslythrough the use of the present invention.

The foregoing has outlined rather broadly the more pertinent andimportant features of the present invention in order that the detaileddescription that follows may be better understood so that the presentcontribution to the art can be more fully appreciated. Additionalfeatures of the invention will be described hereinafter which form thesubject of the claims of the invention. It should be appreciated bythose skilled in the art that the conception and the specificembodiments disclosed may be readily utilized as a basis for modifyingor designing other structures for carrying out the same purposes of thepresent invention. It should also be realized by those skilled in theart that such equivalent constructions do not depart from the spirit andscope of the invention as set forth in the appended claims.

BRIEF DESCRIPTION OF THE DRAWINGS

For a fuller understanding of the nature and objects of the invention,reference should be made to the following detailed description taken inconnection with the accompanying drawings in which:

FIG. 1 is a internal view of the improved multi-tubed catheter of thepresent invention in place in a bronchus of a lung;

FIG. 2 is an enlarged view of a portion of FIG. 1;

FIG. 3 is a longitudinal cross-section of the improved multi-tubedcatheter of the present invention;

FIG. 4 is a cross-sectional view along line 4--4 of FIG. 3;

FIG. 5 is a cross-sectional view along line 5--5 of FIG. 3;

FIG. 6 is a cross-sectional view along line 6--6 of FIG. 3;

FIG. 7 is a cross-sectional view along line 7--7 of FIG. 3;

FIG. 8 is an enlarged elevational view of the front of the improvedmulti-tubed catheter of the present invention; and

FIG. 9 is an enlarged elevational view of the back of the improvedmulti-tubed catheter of the present invention.

Similar reference characters refer to similar part throughout theseveral Figures of the drawings.

DETAILED DISCUSSION

FIG. 1 illustrates a multi-tubed catheter 10 of the present inventionhaving a proximal end 11 and a distal end 12. The multi-tubed catheter10 is shown with the distal end 12 disposed within a cavity of a lung 14and specifically the middle lobe bronchus 16 of the right lung 14. Themulti-tubed catheter 10 is passed into the trachea 18 through anendotracheal tube, a tracheostomy or other means (not shown) whichshould be wellknown known to those skilled in the art.

FIG. 2 is an enlarged view of the multi-tubed catheter 10 in operationwithin the middle lobe bronchus 16 of the right lung 14 which operationwill be described in greater detail hereinafter.

FIG. 3 is a longitudinal cross-sectional view of the multitubed catheter10 with FIGS. 4-7 being various sectional views along the longitudinallength of the multi-tubed catheter 10. The multi-tubed catheter 10comprises a suction tube 20 having a first end 21 and a second end 22.The suction tube 20 is constructed of a flexible tubular material havinga sidewall 23 having an outside surface 23A and an inside surface 23Bdefining a suction tube lumen 24. The first end 21 of the suction tube20 is adapted to be connected to a source of vacuum (not shown). Thesecond end 22 of the suction tube 20 comprises an end wall 25. Aplurality of suction tube openings 27 are disposed in the sidewall 23proximate the second end 22 of the suction tube 20. Reference marks 29are positioned on the outside surface 23A of the suction tube 20 forindication the depth of insertion into the lung 14 of the multi-tubedcatheter 10.

The suction tube is preferably constructed of a flexible syntheticmaterial similar to the materials used for conventional catheters andthe like. When the first end 21 of the suction tube 20 is connected to asource of vacuum (not shown) a suction is produced at the suction tubeopenings 27 for removing material therethrough.

An oxygen tube 30 comprises a first end 31 and a second end 32 and isshaped in the form of a helix and is disposed within the suction tubelumen 24 of the suction tube 20. The oxygen tube 31 comprises a sidewall33 having an outside surface 33A and an inside surface 33B defining anoxygen tube lumen 34 terminating in a coude tip 35. The outside surface33A of the sidewall 33 of the oxygen tube 30 is secured to an insidesurface 23B of the sidewall 23 of the suction tube by suitable means asshould be well known to those skilled in the art.

An oxygen tube end opening 36 is defined in the coude tip 35. Inaddition, oxygen tube sidewall openings 37 are defined in the sidewall33 of the oxygen tube 30. The coude tip 35 comprises a plurality ofopenings including the end opening 36 and the sidewall openings 37 inthe event that one of the end wall opening 36 or the sidewall openings37 becomes blocked

The coude tip 35 is preferably bent at 38 at an angle of approximatelytwenty degrees from a longitudinal axis of multi-tubed catheter 10 fordirecting the insertion of the multi-tubed catheter 10 through a mainbronchus into a selected lung cavity for treatment. The first end 31 ofthe oxygen tube 30 is adapted to be connected to a source of oxygen (notshown) for enabling the flow of oxygen from the oxygen end wall opening36 and sidewall openings 37 into the lung 14 of the patient.

An inflation tube 40 extends between a first end 41 and a second end 42and is shown disposed within the sidewall 23 of the suction tube 20. Theinflation tube 40 includes an inflation tube sidewall 43 defining aninflation tube lumen 44. The first end 41 is adapted to be connected toa source of pressurized gas (not shown). The second end 42 of theinflation tube 40 includes an end wall 45 and a sidewall aperture 47.The sidewall aperture 47 of the inflation tube 40 communicates with aballoon 50 for inflating the balloon 50 upon the application of apressurized gas at the first end 41 of the inflation tube 40. Theballoon 50 provides a means for engaging a sidewall 16A of the bronchus16.

In the preferred embodiment of the invention, the suction tube 20 andthe inflation tube 40 are formed substantially as a single tube whereinthe inflation tube 40 is disposed within the sidewall 23 of suction tube20. However, the inflation tube 40 may also be a separate tube disposedsecured to the outside surface 23A or the inside surface 23B of thesidewall 23 of the suction tube 20 by suitable means as should be wellknown to those skilled in the art. In an alternate form of theinvention, the inflation tube 40 is eliminated and the balloon 50 isinflated through an aperture (not shown) in the sidewall 33 of theoxygen tube 30 position internal the balloon 50.

The balloon 50 is formed of a lightweight, flexible material and forms afirst seal 51 with the second end 22 of the suction tube 20 and forms asecond seal 52 with the oxygen tube 30. Upon the application of a gaspressure at the first end 41 of the inflation tube 40, the balloon 50will inflate as shown in FIG. 3. The effective diameter of the balloon50 may be varied in response to an magnitude of the pressurized airapplied at the first end 41 of the inflation tube 40.

The multi-tubed catheter 10 comprises the suction tube 20, the oxygentube 30, the inflation tube 40 and the balloon 50. The suction tube 20is adapted to convey material out of the lung by means of suction. Theoxygen tube 30 is adapted to provide pure oxygen or an oxygen-rich gassuch as humidified oxygen to the patient. The inflation tube 40 isadapted to inflate the balloon 50 for separating the suction of thesuction tube 20 from the flow of oxygen or an oxygen-rich gas to thepatient of the oxygen tube 30.

The oxygen tube 30 forms a first helical path 61 for the flow of theoxygen from the first end 31 to the second end 32. The suction tubeopenings 27 are preferably of a teardrop-shape and are disposed on afront and back side of the suction tube 20 as shown in FIGS. 8 and 9.The suction tube openings 27 are also formed to be between the helixformed by the oxygen tube 30. Accordingly, the flow of air from thesuction tube openings 27 through the suction tube 20 will follow asecond helical path 62 formed between the outside surface 33A of thesidewall 33 of the oxygen tube 30 and the inside surface 23B of thesidewall 23 of the suction tube 20. A solid or a fluid material such asmucus which travels up the suction tube 12 will similarly travel throughthe suction tube 20 along the second helical path 62. Since the secondhelical path 62 is counter-rotating relative to the first helical path61, there is substantially no resultant torque produced on themulti-tubed catheter 10 due to the flow of gases though the suction tube20 and the oxygen tube 30. In addition, since the suction tube 20comprises two opposed suction tube openings 27 as shown in FIGS. 8 and9, there is no unbalanced torque or force produced by the air flowthrough the suction tube openings 27 into the suction tube 20. It isbelieved that the second helical path 62 also prevent the blockage ofthe suction tube 20 and make the removal of material more efficient.

The multi-tubed catheter of the present invention is utilized in thefollowing way. Humidified 100% oxygen or similar gas is introduced underpressure into oxygen tube 30. The distal end 12 of the multi-tubedcatheter 10 is passed through an endotracheal tube (ETT), atracheostomy, or other means through the trachea 18 and directed bymeans of the coude tip 35 into a selected bronchus 16 of the lung 14.While the multi-tubed catheter 10 is inserted, the balloon 50 isuninflated. The coude tip 35 is lodged in the bronchus 16. Preferably,coude tip 35 should be lodged as far as possible into the lung 14. Theuser may gauge the depth of penetration into the bronchus 16 by means ofthe reference marks 29. Generally, for an adult, a depth of 400 mm issufficient; preferably, a length of 100 mm of the unitary portion of themulti-tubed catheter 10 should remain outside of the body of thepatient.

When the multi-tubed catheter 10 is fully inserted, a small amount ofpressurized gas such as air is introduced into the first end 41 of theinflation tube 50 by means such as a lockable syringe or the like. Thepressurized gas will cause the diameter of balloon 50 to expand so thatballoon 50 will engage the sidewall 16A of the bronchus 16. The balloon50 may be designed to have a maximum diameter of between 3.0 mm. and20.0 mm depending on the size of the patient or lung cavity to betreated. The balloon 18 will generally be fully inflated with less than10.0 cc. of a gas such as air.

A suction of 200-600 mm Hg is applied to the first end 21 of the suctiontube 20. The suction may be controlled by suction regulator (not shown)such as "Luer lock" which should be well known to those skilled in theart. Suction may be applied for periods in excess of 15 seconds.

When the balloon 50 is in contact with the sidewall 16A of the bronchus16, multi-tubed catheter 10 can be used to physically dislodge thick andtenacious secretions from the bronchus by slightly withdrawing themulti-tubed catheter 10 so that the balloon 50 may mechanically removesecretions from the sidewall 16A of the bronchus 16.

With oxygen being forced into the lung 14 through oxygen tube 30, andsuction being applied through suction tube 20, the multi-tubed catheter10 may be gradually and totally pulled out of the bronchus 14 toscraping any thick and tenacious secretions from the sidewall 16A of thebronchus 16. As the balloon 50 passes through wider cross-sections ofbronchus 16, the balloon 50 is further inflated to maintain contactbetween balloon 50 and the sidewall 16A of the bronchus 16. As thesecretions are dislodged by the motion of balloon 50, the dislodgedmatter is drawn through suction tube openings 27 in suction tube 20 andis conducted out of the multi-tubed catheter 10 through cavity suctiontube lumen 24.

Simultaneously, oxygen entering the lung 14 through oxygen tube 30 andcoude tip 35 is aerating the newly-clean bronchi. In addition to itsfunction in dislodging secretions from the sidewall 16A of the bronchus16, the balloon 50 may serve a second function as a partial blockageagainst for the escape of oxygen from the bronchus 16. This blockagewill result in a high oxygen pressure within the lung 14. This isdesirable because oxygen exchanges into lung tissue more efficiently atthis higher pressure. If, for any reason, suction must suddenly bestopped, the balloon 50 may be deflated rapidly allowing the multi-tubedcatheter 10 to be removed quickly in a conventional manner.

In a preferred embodiment of the invention, the source of vacuum (notshown) connected to the first end 21 of the suction tube 20, the sourceof oxygen (not shown) connected to the first end 31 of the oxygen tube30, and the source of pressurized gas connected to the first end 41 ofthe inflation tube 50 are regulated and appropriately balanced. If thepressure applied to the balloon 50 is greater than the pressure appliedto the oxygen tube 30, then a distal pressured oxygen known in the artas a (CPAP) is created from the occluding balloon and the oxygenemanating from the oxygen tube will be flooded into the lungs. If thepressure applied to the balloon 50 is less than the pressure applied tothe oxygen tube 30, then the pressure of the oxygen from the oxygen tube30 will deflate the balloon 50 enabling the flow of oxygen around theoutside of the balloon 50. The flow of oxygen around the outside of theballoon 50 will convey any material to the suction tube opening 37.

The present invention provides many advantage over the prior art. Thepresent invention physically dislodges material in a more effective waythan is possible with the simple single tube of the prior art. Theballoon 50 starts deep in a bronchial cavity, and as the balloon 50 ispulled out, the balloon 50 scrapes the mucus from the sidewall 16A ofthe bronchus 16 until all the mucus is drawn out. This methodicalsuctioning is more efficient than that of previous devices because,instead of suctioning just what is near the suction tip of an ordinarycatheter, an entire branch of the bronchotracheal tree can besystematically cleaned.

In addition, once the balloon 50 is inflated, a substantial seal isformed between the oxygen entering the lung through coude tip 35 and thesuction through suction tube openings 27. Because of the seal, there isa relatively high pressure of oxygen against the alveoli, for a moreefficient oxygen exchange into the lung tissue. Also, the combination ofoutward pressure of oxygen and suction through the suction tube willtend to cause mucus near the coude tip 35 to be pushed around theballoon 50 and into the suction tube openings 27 of suction tube 20,thus further enhancing the efficiency of material removal.

Moreover, the combination of oxygen pressure into the lung and suctionout of the lung enables the user of relatively high levels of suction,as high as 600 mm Hg, without damaging tissue in the lung. Higher levelsof suction enable greater efficiency in removing materials from thelungs.

The multi-tubed catheter 10 of the present invention is generally madeof polyvinyl chloride (PVC), though other types of rubber of plasticcould be used. The balloon 50 may be constructed of a flexible plasticmaterial such as silicone or the like. In one embodiment of theinvention, the oxygen tube 30 is constructed of a sightly more rigidmaterial relative to the suction tube 20. The sightly more rigid oxygentube 30 will inhibit the twisting of the multi-tubed catheter 10. Inaddition, the sightly more rigid oxygen tube 30 will prevent thecollapse of the suction tube 20 in the event that the suction tubeopening 37 are block by the material. It is preferable that themulti-tubed catheter 10 be of a material that will withstandtransportation and changes in temperature.

The multi-tubed catheter 10 can be designed within a wide range ofdimensions for use in specific needs, such as with infants. The overalllength may be between 300-600 mm, and the outside diameter of thesuction tube 20 of the multi-tube catheter 10 may be between 2-7 mm.Generally, however, the relative diameters of the suction tube 20, theoxygen tube 30 and the inflation tube 40 should be: suction tube 20-50%of the total external diameter; oxygen tube 30-30% of the externaldiameter; and inflation tube 40-20% of the external diameter. Themaximum diameter of the balloon 50 may vary from between 3-20 mm.

The present disclosure includes that contained in the appended claims aswell as that of the foregoing description. Although this invention hasbeen described in its preferred form with a certain degree ofparticularity, it is understood that the present disclosure of thepreferred form has been made only by way of example and that numerouschanges in the details of construction and the combination andarrangement of parts may be resorted to without departing from thespirit and scope of the invention.

What is claimed is:
 1. Apparatus for removing material from a bronchialcavity of a lung and for simultaneously aerating the lung, comprising:asuction tube having a first end and a second end with a suction tubelumen extending therebetween; said suction tube being sufficientlyflexible and sufficiently small in diameter to enter the bronchialcavity of the lung; said suction tube defining a plurality of suctiontube openings proximate said second end of said suction tube; an oxygentube having a first end a second end with an oxygen tube lumen extendingtherebetween; said oxygen tube being disposed within said suction tubelumen and being secured to said suction tube lumen; said oxygen tubedefining an oxygen tube opening proximate said second end of said oxygentube; an inflatable balloon secured to said suction tube between saidsuction tube opening and said oxygen tube opening for engaging a surfacein the lung; said inflatable balloon being adapted to physicallydislodge tenacious material from the surface in the lung upon a movementof said inflatable balloon relative to the surface in the lung; meansfor connecting said first end of said suction tube to a source of vacuumfor conveying material out of the lung by suction; means for connectingsaid first end of said oxygen tube to a source of oxygen forsimultaneously conveying oxygen into the lung; and each of saidplurality of suction tube openings has a general shape of a teardrop forfacilitating the entry of tenacious material from the surface of thelung.
 2. Apparatus for removing material as set forth in claim 1,wherein said oxygen tube comprises a plurality of oxygen tubeopenings;an end wall opening of said plurality of oxygen tube openingsbeing disposed in said second end of said oxygen tube; and a sidewallopening of said plurality of oxygen tube openings being disposed in asidewall of said oxygen tube.
 3. Apparatus for removing material as setforth in claim 1, including an inflation tube having a first and asecond end with an inflation tube lumen extending therebetween;saidinflation tube defining an inflation tube opening proximate said secondend of said inflation tube; and means for connecting said first end ofsaid inflation tube to a source of gas pressure for inflating saidballoon.
 4. Apparatus for removing material as set forth in claim 3,wherein said inflation tube is disposed generally parallel to saidsuction tube.
 5. Apparatus for removing material as set forth in claim3, wherein said inflation tube is disposed within said suction tube. 6.Apparatus for removing material as set forth in claim 3, wherein saidinflation tube is disposed within a sidewall of said suction tube. 7.Apparatus for removing material from a bronchial cavity of a lung andfor simultaneously aerating the lung, comprising:a suction tube having afirst end and a second end with a suction tube lumen extendingtherebetween; said suction tube being sufficiently flexible andsufficiently small in diameter to enter the bronchial cavity of thelung; said suction tube defining a plurality of suction tube openingsproximate said second end of said suction tube; an oxygen tube having afirst end a second end with an oxygen tube lumen extending therebetween;said oxygen tube being disposed within said suction tube lumen and beingsecured to said suction tube lumen; said oxygen tube defining an oxygentube opening proximate said second end of said oxygen tube; aninflatable balloon secured to said suction tube between said suctiontube opening and said oxygen tube opening for engaging a surface in thelung; said inflatable balloon being adapted to physically dislodgetenacious material from the surface in the lung upon a movement of saidinflatable balloon relative to the surface in the lung; means forconnecting said first end of said suction tube to a source of vacuum forconveying material out of the lung by suction; means for connecting saidfirst end of said oxygen tube to a source of oxygen for simultaneouslyconveying oxygen into the lung; said oxygen tube is helically formedwithin said suction tube lumen; and said oxygen tube being secured tosaid suction tube lumen for forming a first helical path for the flow ofthe oxygen within said oxygen tube and for forming a second helical pathwith said suction tube lumen for said suction tube.
 8. Apparatus forremoving material as set forth in claim 7, wherein said oxygen tubecomprises a plurality of oxygen tube openings;an end wall opening ofsaid plurality of oxygen tube openings being disposed in said second endof said oxygen tube; and a sidewall opening of said plurality of oxygentube openings being disposed in a sidewall of said oxygen tube. 9.Apparatus for removing material as set forth in claim 7, including aninflation tube having a first and a second end with an inflation tubelumen extending therebetween;said inflation tube defining an inflationtube opening proximate said second end of said inflation tube; and meansfor connecting said first end of said inflation tube to a source of gaspressure for inflating said balloon.
 10. Apparatus for removing materialas set forth in claim 9, wherein said inflation tube is disposedgenerally parallel to said suction tube.
 11. Apparatus for removingmaterial as set forth in claim 9, wherein said inflation tube isdisposed within said suction tube.
 12. Apparatus for removing materialas set forth in claim 9, wherein said inflation tube is disposed withina sidewall of said suction tube.
 13. A method for removing material froma lung and for simultaneously aerating the lung with a multi-tubedcatheter having a suction tube and an oxygen tube with an inflatableballoon interposed therebetween, comprising the steps of:inserting themulti-tubed catheter into the lung; connecting the oxygen tube to asource of oxygen for conveying oxygen into the lung; inflating theballoon to engage a surface in the lung; at least partially withdrawingthe multi-tubed catheter from the lung to dislodge material from thelung; and connecting the suction tube to a source of vacuum forconveying material out of the lung by suction.